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[Nas]

So sorry this happened Rosie.
Were you on sequential or continuous HRT? I’m guessing continuous.

There has been a fundamental error made here on behalf of the health service. Post meno bleeding ( once settled on continuous HRT after 6 months ) absolutely must be investigated under the 2 week cancer pathway. They must do a scan ( abdominal or internal) to measure womb lining and if deemed necessary, a hysteroscopy.

Take your time, but start thinking about how you want to proceed with this. Starting with your GP. Did they do a referral to gynae? Did gynae contact you ? What made them think you were peri ?

Hugs 🤗 x

[Mary G]

Rosie, I'm so sorry this has happened to you.  It is medical negligence and I would have no hesitation in initiating proceedings against the NHS.

I would find a lawyer to represent me.  If you google NHS medical negligence a whole load of different organisations come up.

Something similar happened to a friend of mine years ago. The NHS refused to give her a hysterectomy when she was diagnosed with cervical cancer.  God knows why, it was completely insane. They later told her husband he could sue but he couldn't face it.

If women were screened properly with regular scans, much of this could be avoided.

[Nas]

Hope you are okay Rosie? X

[Rosie Roo]

No I’m not ok Nas … it was when i mentioned at my post operation appt ( 4 months after op!) about the long wait for the hysteroscopy that I learned that I had waited so long  because the Gp had me down for a routine  referral as opposed to a 2 week one .
 So with the back log at the hospital I waited 8 months for a biopsy  . I wasn’t unduly worried because I was given the impression that the Gp wasn’t . Size of fibroids were mentioned etc . Had a diagnosis of womb cancer and then total hysterectomy . No further HRT allowed . When I asked how the hospital had triaged me I was told that because I was peri that I didn’t qualify for the 2 week path way ! My point is who the hell decided that ! I’m now 59 and have been on hrt for years so how did they come to that conclusion !
Going to talk  to Gp tomorrow’ and take it from there . Missing my HRT as got loads of symptoms.. just feeling totally let down. And all the comments on here have validated how I feel really . Thanks ladies xx

[Rosie Roo]

I mean if I had been seen sooner .. it may have not turned to cancer but remained a thick lining with a small polyp …that could have been removed .
🥴

[Minusminnie]

Rosie
My husband persued a GP's medical negligence for a different reason. 
Emailed all written information available to a lawyer on a 'No win No fee' basis.  First lawyer wouldn't touch it but second lawyer went much further asking for more information and sought advice of a medic. The second lawyer eventually went no further but it gave a feeling that they had at least looked at it in some depth.  With the possibiltity of needing deeper pockets my husband went no further.  Some consolation though through the second lawyer.

Think I'm trying to say that you might feel better just trying on a No win No fee basis and you may find that they take your case up.

[Penguin]

No I’m not ok Nas … it was when i mentioned at my post operation appt ( 4 months after op!) about the long wait for the hysteroscopy that I learned that I had waited so long  because the Gp had me down for a routine  referral as opposed to a 2 week one .
 So with the back log at the hospital I waited 8 months for a biopsy  . I wasn’t unduly worried because I was given the impression that the Gp wasn’t . Size of fibroids were mentioned etc . Had a diagnosis of womb cancer and then total hysterectomy . No further HRT allowed . When I asked how the hospital had triaged me I was told that because I was peri that I didn’t qualify for the 2 week path way ! My point is who the hell decided that ! I’m now 59 and have been on hrt for years so how did they come to that conclusion !
Going to talk  to Gp tomorrow’ and take it from there . Missing my HRT as got loads of symptoms.. just feeling totally let down. And all the comments on here have validated how I feel really . Thanks ladies xx

I think you can make a complaint re PALS, although I think that may apply to hospital negligence rather than GP. I would very much want to know why the GP classed you as peri and would want it shown that they had followed guidelines in doing so. I thought they classed women as post menopause at a younger age but I may be wrong. It could be worth raising this with your MP as it sounds like a wider change is needed unless it was something limited to an error made by your particular GP.
Be careful with no win no fee though, they take an awful lot of any payout, plus they made my friend take out insurance to cover any potential losses their side.

[Nas]

It sounds like the fault may lie with your GP, as they are your first port of call. They have your records and should ask the relevant questions.

When I had my third episode of pm bleeding in august, I literally emailed the surgery, telling them so. They then passed that information directly to the gp, who actioned a 2week pathway referral that day.

Appointment came through within days and biopsy done a week later.

Your GP has let you down. I would write to the practice manager and ask to arrange a meeting between you, the practice manager and the GP who did the referral. The GP will know you are post menopausal by looking at the type of  Hrt you are on.

Did you get in touch with either gynae or the GP, after you had received no appointment within 2 weeks ? Gynaecology would be able to tell you if a referral had been made and if so, what type.

I think i would have also reminded the Gp that NICE guidelines recommend a referral on the 2 week pathway and could they double check this has been actioned, as you’ve been waiting so long.

Hope you get some much deserved answers soon.

[Penguin]

It sound like the fault may lie with your GP, as they are your first port of call. They have your records and should ask the relevant questions.

When I had my third episode of pm bleeding in august, I literally emailed the surgery, telling them so. They then passed that information directly to the gp, who actioned a 2week pathway referral that day.

Appointment came through within days and biopsy done a week later.

Your GP has let you down. I would write to the practice manager and ask to arrange a meeting between you, the practice manager and the GP who did the referral. The GP will know you are post menopausal by looking at the type of  Hrt you are on.

It’s the fault of the GP, not the hospital.

Did you get in touch with either gynae or the GP, after you had received no appointment within 2 weeks ? Gynaecology would be able to tell you if a referral had been made and if so, what type.

Yes you're right Nas, the hospital would only be going on what the GP sent them, and if GP requested a routine referral, then thatis what would have been actioned. I think it crucial to find out on what basis the GP did it as routine, ie how did they make the decision of peri vs post menopausal. What do official guidelines say about when a woman becomes post menopausal.

[Nas]

Exactly penguin.
The GP is totally at fault here (I think)

The GP did not read Rosie’s notes regarding her HRT regimen. Assuming she spoke directly to a GP, then she would have been able to convey the fact that she is 59, been on x type of HRT for a number of years, but is now bleeding. That should send alarm bells to the GP to initiate a 2 week pathway referral.

Nice guidelines stipulate, that any unscheduled bleeding once post menopause ( 12 months from last natural period ) should be investigated. Rosie was on HRT for years ( and settled on this regime I'm assuming?).

Unless the GP did an urgent referral but it got overlooked by the hospital and marked as routine?

Either way, start with the GP.

[Rosie Roo]

Thank you ladies . Going to speak to her tomorrow and get some clarity . The issue is I’ve got to go forward under the hospital for the next three years and I’ve lost my trust at the moment. And feel totally like I don’t matter. As if the diagnosis wasn’t  bad enough, then the op , then recovery… then finding out how they triaged me ! My head is spinning . X

[Penguin]

https://www.nhs.uk/conditions/menopause/

[Penguin]

Rosie the above link puts the upper age for 'usual' menopause to be at 55. It doesn't differentiate between whether on hrt or not,  therefore you could quote this.

Also look at the NICE guidelines for diagnosing menopause - google it, there is a dedicated page for how to diagnose it. It again mentions women being over 55 and bleeding in menopause warranting a 2WW referral for endometrial cancer. Again, it doesn't say anywhere (from what I read) that hrt delays menopause. So what specifically was the GP using to decide you were peri and therefore didn't warrant a 2WW referral. Ask them to show you! If they can't, then that is the basis for your complaint.

[Rosie Roo]

Thank you Penguin !!  Really appreciate that .x

[Nas]

Hi Rosie,
How are you doing? Any joy with speaking to your GP at all?